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Trials designed to inform clinical practice in the real world are known as pragmatic trials. They are often described as a focus on the practical aspects of designing a study, including the recruitment process and consent, adhering and the use of standard equipment.
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Another example of a practical trial is the Home Blood Pressure Management (HBPM) study, which employed a variety of investigators and participants from different geographical regions. 무료 프라그마틱 of heterogeneity is necessary for practical trials to be valid and helps to reduce bias in the results. However, too much heterogeneity can lead to issues with the design of the trial.
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The purpose of pragmatic trials is to mimic real-life scenarios and gain maximum validity externally. They are typically commissioned by policymakers and practitioners to guide their decisions. They can be used to determine the causality of an intervention with its outcomes. However, they shouldn't be used as a substitute for explanation trials.
The pragmatism idea is controversial and there are questions about whether pragmatic trials should be used to replace explanatory trials or complement them. Schwartz and Lellouch1 made an distinction between explanation-based studies, which confirm the physiological hypothesis or clinical hypothesis, and pragmatic trials, that inform policy and practice decision-making. They also proposed an approach to pragmatic trials, called PRECIS.2 This tool sought to define the characteristics of a practical trial that include recruitment, design and delivery of the intervention, as well as the follow-up.
The number of pragmatic trials is growing. A recent Medline search using the words pragmatic and naturalistic, limited to randomised controlled trials (RCTs), returned 34 articles. These are highlighted in red on Figure 2. This suggests that the health sciences community has become more aware of the importance of pragmatism. It is important to remember, however, that the majority of these studies were conducted in primary-care settings.